What Causes Goiter?

Your thyroid is a gland found in your neck just below your Adam’s apple. It secretes hormones that help regulate bodily functions, including metabolism, the process that turns food into energy. It also regulates heart rate, respiration, digestion,... Read More

Your thyroid is a gland found in your neck just below your Adam’s apple. It secretes hormones that help regulate bodily functions, including metabolism, the process that turns food into energy. It also regulates heart rate, respiration, digestion, and mood. A condition that increases the size of your thyroid is called a goiter. A goiter may develop in anyone, but is more common in women. Sometimes, it affects the way the thyroid functions.

The Types of Goiters

Goiters have many causes. As a result, there are different types. These include:

Colloid Goiter (Endemic)

A colloid goiter develops from the lack of iodine, a mineral essential to the production of thyroid hormones. People who get this type of goiter usually live in areas where iodine is scarce.

Nontoxic (Sporadic)

The cause of a nontoxic goiter is usually unknown, though it may be caused by medications like lithium. Lithium is used to treat mood disorders such as a bipolar disorder. Nontoxic goiters don’t affect the production of thyroid hormone, and thyroid function is healthy. They are also benign.

Toxic Nodular or Multinodular Goiter

This type of goiter forms one or more small nodules as it enlarges. The nodules produce their own thyroid hormone, causing hyperthyroidism. It generally forms as an extension of a simple goiter.

What Causes a Goiter?

Iodine deficiency is the main cause of goiters. Iodine is essential to helping your thyroid produce thyroid hormones. When you don’t have enough iodine, the thyroid works extra hard to make thyroid hormone, causing the gland to grow larger.

Other causes include the following:

Graves’ Disease

Graves’ disease occurs when your thyroid produces more thyroid hormone than normal, which is known as hyperthyroidism. The excessive production of hormones makes the thyroid increase in size.

Hashimoto’s Disease

When you have Hashimoto’s disease, the thyroid doesn’t produce enough thyroid hormone, causing hypothyroidism. The low thyroid hormone causes the pituitary gland to make more thyroid-stimulating hormone (TSH), which causes the thyroid to swell.

Inflammation

Some people develop thyroiditis, an inflammation of the thyroid that can cause a goiter.

Nodules

Solid or fluid-containing cysts may appear on the thyroid and cause it to swell. These nodules are often noncancerous.

Thyroid Cancer

Cancer may affect the thyroid, which causes swelling on one side of the gland. Thyroid cancer is not as common as the formation of benign nodules.

Pregnancy

Being pregnant can sometimes cause the thyroid to become larger.

Who Is at Risk for a Goiter?

You may be at risk for a goiter if you:

Have a family history of thyroid cancer, nodules, and other problems that affect the thyroid.

Don’t get enough iodine in your diet.

Have a condition that decreases the iodine in your body.

Are female. Women have a higher risk for goiter than men.

Are over the age of 40. Aging may affect the health of your thyroid.

Are pregnant or experiencing menopause. These risk factors are not easily understood, but pregnancy and menopause may trigger problems in the thyroid.

Have radiation therapy in the neck or chest area. Radiation may change the way your thyroid functions.

What Are the Symptoms of a Goiter?

The primary symptom of a goiter is noticeable swelling in your neck. If you have nodules on your thyroid, they may range in size from very small to very large. The presence of nodules may increase the appearance of swelling.

Other symptoms include the following:

difficulty swallowing or breathing

coughing

hoarseness in your voice

dizziness when you raise your arm above your head

How Is a Goiter Diagnosed?

Your doctor will check for neck for swelling. They will also order a number of diagnostic tests that include these below:

Blood Tests

Blood tests can detect changes in hormone levels and an increased production of antibodies, which are produced in response to an infection or injury.

Thyroid Scan

Your doctor may order scans of your thyroid. These scans show the size and condition of your goiter.

Ultrasound

An ultrasound produces images of your neck, the size of your goiter, and whether there are nodules. Over time, an ultrasound can show changes in those nodules and the goiter.

Biopsy

A biopsy is a procedure that involves taking small samples of your thyroid tissue. The samples are sent to a laboratory for examination.

How Is a Goiter Treated?

Your doctor will decide on a course of treatment based on the size and condition of your goiter, and symptoms associated with it. Treatment is also based on health problems that contribute to the goiter.

Medications

If you have hypothyroidism or hyperthyroidism, medications to treat these conditions may be enough to shrink a goiter. Medications (corticosteroids) to reduce your inflammation may be used if you have thyroiditis.

Surgeries

Surgical removal of your thyroid, known as thyroidectomy, is an option if yours grows too large or doesn’t respond to medication therapy.

Radioactive Iodine

In people with toxic multinodular goiters, RAI may be necessary. The RAI is ingested orally, and then travels to your thyroid through your blood, where it destroys the excess tissue.

Home Care

Depending on your type of goiter, you may need to increase or decrease your iodine intake at home.

If a goiter is small and doesn’t cause any problems, you may require no treatment at all.

What Is to Be Expected in the Long Term?

Many goiters disappear with treatment, while others may increase in size. Speak with your doctor if your symptoms increase or become worse. If your thyroid continues to make more hormones than you need, this can lead to hyperthyroidism. Not making enough hormones may lead to hypothyroidism.

Medically reviewed by Mark R Laflamme, MD on January 28, 2016 — Written by Brindles Lee Macon and Winnie Yu